CONCERNING reports have recently revealed that more than 3,000 people have died in the last year before a decision to grant them access to NHS funding for their care needs could be made – and demonstrated why the current system is in need of an overhaul.
At present, support through Continuing Healthcare Funding (CHC) helps patients who have care needs above and beyond traditional social care support and is funded by the NHS.
Applications for funding should take no longer than 28 days to deal with, but analysis of Clinical Commissioning Groups across the country revealed 3,400 people died in 2017/18 while awaiting a decision on their application.
The outstanding applications mean many elderly people who required health and social care support will have been forced to fund their own care – often relying on family members, or left with no other option than to sell off their homes in order to make up the shortfall.
For many of the loved ones left behind, they may now face a long and difficult battle to recover the costs.
It’s important to point out, first and foremost, that it is a legal requirement that the NHS fund the care of people who are assessed as having a primary health need.
For the most part, those who qualify have complex, life-limiting conditions, such as Parkinson’s and Alzheimer’s, and home care is often simply not an option.
Despite this, the path to access such funding is convoluted. And that’s if the patient and the family are even aware that it exists in the first place.
The 3,000 figure is likely to be a drop in the ocean, with many more living applicants still awaiting initial, or regular follow up assessments; or currently involved in the appeals process. We are currently representing hundreds of people who are simply in limbo awaiting the outcome of their claim.
The recent figures are a new development in a string of criticisms. A report earlier this year from the Public Accounts Committee (PAC) claimed that the current system is ‘failing’ people with continuing healthcare needs such as Alzheimer’s and multiple sclerosis; indicating that many people have their care compromised because no one had made them aware of the funding available or, in some cases, the decision was made too late.
And even in cases where we are successful in accessing retrospective funding, in many ways the damage is done; leaving relatives feeling the undue stress of topping up fees unsure of whether they would ever see that money again, and leaving elderly people despondent that they have been unable to live their lives as comfortably as they could have otherwise done.
The PAC also raised concerns over the inconsistency and delays in the funding scheme.
For many patients, the application can be complex and if they do manage to navigate the process, they are kept waiting.
While the application process should take no longer than 28 days according to NHS guidelines, almost 25,000 cases– a third of the total number of assessments – took longer to assess, 2,500 took more than a year, and a handful of patients found themselves waiting almost three years for a decision.
Not only is the assessment process inconsistent, there is a lack of funding to actually carry out the assessments. While funded by the NHS, CCGs who administer funds locally, have been tasked by NHS England to find £855m in efficiency savings from the budgets for CHC and nursing support by 2021.
But how they can do this without limiting the care packages available is another question – efficiency savings will only add to financial pressures already placed on clinical commissioning groups, and, at a time where an ageing population means more people will require CHC funding in the future, it will ultimately mean more people missing out on the care they need.
Consistency and transparency is key in reforming the system, and ensuring that those who are eligible for Continuing Healthcare Funding have access to the funding in a timely manner.
The social care Green Paper is due out later this year, with the Government promising to ‘do better’, but what does that look like, and what does it do to address the healthcare side of the health and social care divide? Both are in need of improvement.
Until a fair and consistent approach to assessing people is in place and followed across the country, this issue will continue at the detriment to the wellbeing of thousands of people and their families.
The Government must step in and ensure that people with continuing healthcare needs are aware of the help available – and that those eligible receive essential care in an efficient, timely and compassionate manner.
James Urquhart-Burton is a partner and specialist in recovering care home costs at Simpson Millar.